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[1] Does the jurisdiction require that any hospitals offer hepatitis B vaccine to any employees of the hospital, or ensure that any such employees are vaccinated with hepatitis B vaccine?

[2] Does the jurisdiction require that any hospitals offer influenza vaccine to any employees of the hospital, or ensure that any such employees are vaccinated with influenza vaccine?

[3] Does the jurisdiction require that any hospitals offer measles/mumps/rubella (MMR) vaccine (or any component thereof) to any employees of the hospital, or ensure that any such employees are vaccinated with MMR vaccine?

[4] Does the jurisdiction require that any hospitals offer varicella vaccine to any employees of the hospital, or ensure that any such employees are vaccinated with varicella vaccine?

[5] Does the jurisdiction require that any hospitals offer pneumococcal polysaccharide vaccine to any employees of the hospital, or ensure that any such employees are vaccinated with pneumococcal polysaccharide vaccine?

[6] If any hospitals are required to ensure that any hospital employees are vaccinated with hepatitis B, influenza, MMR, varicella or pneumococcal vaccine, does the jurisdiction provide any medical, religious or philosophical exemptions to such administration requirements?

[7] Does the jurisdiction require that any hospitals offer any inpatients of the hospital influenza vaccine, or ensure that any inpatients are vaccinated with influenza vaccine?

[8] Does the jurisdiction require that any hospitals offer any inpatients of the hospital pneumococcal polysaccharide vaccine, or ensure that any inpatients are vaccinated with pneumococcal polysaccharide vaccine?

[9] If any hospitals are required to ensure that any hospital inpatients are vaccinated with influenza or pneumococcal vaccines, does the jurisdiction provide any medical, religious or philosophical exemptions to such administration requirements?

[10] Does the jurisdiction require that any individual healthcare providers offer any vaccinations to any patients, or ensure that any patients are vaccinated with any vaccines?

[11] If any individual providers are required to ensure that any of their patients are vaccinated with any vaccines, does the jurisdiction provide any medical, religious or philosophical exemptions to such administration requirements?

[12] Does the jurisdiction require that any ambulatory care facilities offer any vaccinations to any employees, or ensure that any employees are vaccinated with any vaccines?

[13] If any ambulatory care facilities are required to ensure that any employees are vaccinated with any vaccines, does the jurisdiction provide any medical, religious or philosophical exemptions to such administration requirements?

[14] Does the jurisdiction require that any ambulatory care facilities offer any vaccinations to any patients, or ensure that any patients are vaccinated with any vaccines?

[15] If any ambulatory care facilities are required to ensure that any patients are vaccinated with any vaccines, does the jurisdiction provide for any medical, religious or philosophical exemptions to such administration requirements?

[16] Does the jurisdiction require that any correctional facilities or juvenile detention centers offer any vaccinations to any inmates or juveniles, or ensure that any inmates or juveniles are vaccinated with any vaccines?

[17] If any correctional centers or juvenile detention centers are required to ensure that any inmates or juveniles are vaccinated with any vaccines, does the jurisdiction provide for any medical, religious or philosophical exemptions to such administration requirements?

[18] Does the jurisdiction require that any residential facilities for the developmentally disabled or mentally retarded offer any residents any vaccinations, or ensure that any residents are vaccinated with any vaccines?

[19] If any residential facilities for the developmentally disabled or mentally retarded are required to ensure that any residents are vaccinated with any vaccines, does the jurisdiction provide for any medical, religious or philosophical exemptions to such administration requirements?

[256] For Texas requirements, see 25 Tex. Admin. Code § 96.202, requiring that all publicly owned or financed institutions that provide health services, even if health services are not their primary purpose, shall comply with state and federal laws regarding bloodborne pathogen exposure. The federal OSHA requirement, 29 CFR § 1910.1030, requires that employers make available the hepatitis B vaccine series to all employees who have occupational exposure. If the employee initially declines the vaccine but changes their mind while still covered under the standard, the employer shall make hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge.Note also 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.

[257] For Texas requirements, see Tex. Health & Safety Code § 161.0052(b) providing that the executive commissioner of the Health and Human Services Commission by rule shall require a hospital to inform each elderly person admitted to the hospital for a period of 24 hours or more that the pneumococcal and influenza vaccines are available. If the elderly person requests a vaccine, and if a physician, or an advanced nurse practitioner or physician assistant on behalf of a physician, determines that the vaccine is in the person's best interest, the hospital must make the vaccination available to the person before the person is discharged from the hospital.

[258] For Texas requirements, see Tex. Health & Safety Code § 161.0052(b) providing that the executive commissioner of the Health and Human Services Commission by rule shall require a hospital to inform each elderly person admitted to the hospital for a period of 24 hours or more that the pneumococcal and influenza vaccines are available. If the elderly person requests a vaccine, and if a physician, or an advanced nurse practitioner or physician assistant on behalf of a physician, determines that the vaccine is in the person's best interest, the hospital must make the vaccination available to the person before the person is discharged from the hospital.

[259] For Texas requirements, see Tex. Health & Safety Code § 161.004(c) and 25 Tex. Admin. Code § 97.101(d). Tex. Health & Safety Code § 161.004(c) provides that physicians must administer any needed immunizations or refer for immunization children admitted to a hospital ER or outpatient clinic. 25 Tex. Admin. Code § 97.101(d) requires all physicians and other health care providers who provide health care to children to administer needed vaccines or refer every child needing immunization to another provider. Note also that Tex. Health & Safety Code § 161.0052(d) provides that the Texas State Board of Medical Examiners by rule shall require a physician responsible for the management of a physician's office that provides ongoing medical care to elderly persons to offer, to the extent possible as determined by the physician, the opportunity to receive the pneumococcal and influenza vaccines to each elderly person who receives ongoing care at the office. However, this does not constitute an offer requirement as the physician may determine that it is not feasible to offer the vaccine to his/her patients.

[260] For Texas, for medical exemptions to the immunization administration requirements of Tex. Health & Safety Code § 161.004(c) and 25 Tex. Admin. Code § 97.101(d), see Tex. Health & Safety Code § 161.004(d)(2) and 25 Tex. Admin. Code § 97.101(g). Tex. Health & Safety Code § 161.004(d)(2) provides that children are exempt from the immunization administration requirements of § 161.004 where the vaccine is medically contraindicated by any physician licensed in the United States. 25 Tex. Admin. Code § 97.101(g) provides that children are exempt from immunization administration requirements of 25 Tex. Admin. Code § 97.101(d) where the immunization is medically contraindicated based on an examination of the child by a physician licensed to practice anywhere in the United States.

[261] For Texas, for religious exemptions to the immunization administration requirements of Tex. Health & Safety Code § 161.004(c) and 25 Tex. Admin. Code § 97.101(d), see Tex. Health & Safety Code § 161.004(d)(1) and 25 Tex. Admin. Code § 97.101(g). Tex. Health & Safety Code § 161.004(d)(1) provides that children are exempt from the immunization administration requirements of § 161.004 where the child’s parent, guardian, or conservator states that the vaccination is being declined for reasons of conscience, including a religious belief. 25 Tex. Admin. Code § 97.101(g) provides that children are exempt from the immunization administration requirements of 25 Tex. Admin. Code § 97.101(d) where the immunization conflicts with the tenets of an organized religion to which the parent or guardian belongs.

[262] For Texas, for philosophical exemptions to the immunization administration requirements of Tex. Health & Safety Code § 161.004(c), see § 161.004(d)(1), providing that children are exempt from immunization administration requirements where the child’s parent, guardian, or conservator states that the vaccination is being declined for reasons of conscience, including a religious belief.

[263] For Texas requirements, see 25 Tex. Admin. Code § 96.202, relating to all publicly owned or financed institutions, and 25 Tex. Admin. Code § 117.34(a)(1), relating to “end stage renal disease facilities.” 25 Tex. Admin. Code § 96.202 provides that all publicly owned or financed institutions that provide health services, even if health services are not their primary purpose, shall comply with state and federal laws regarding bloodborne pathogen exposure. The federal OSHA requirement, 29 CFR § 1910.1030, requires that employers make available the hepatitis B vaccine series to all employees who have occupational exposure. If the employee initially declines the vaccine but changes their mind while still covered under the standard, the employer shall make hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge. 25 Tex. Admin. Code § 117.34(a)(1) incorporates by reference 29 CFR § 1910.1030. Note also 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include ambulatory surgical centers, birthing centers, abortion facilities, end stage renal disease facilities, and freestanding emergency medical care facilities, among others, licensed under the Texas Health and Safety Code.

[264] For Texas requirements, see 25 Tex. Admin. Code § 117.34, relating to “end stage renal disease facilities”. 25 Tex. Admin. Code § 117.34 requires facility staff to make available hepatitis B vaccine to all patients who are susceptible, provided that they are willing to pay for the vaccine. Note also that Tex. Health & Safety Code § 161.0052(c) provides that the executive commissioner of the Health and Human Services Commission by rule shall require an end stage renal disease facility to offer, to the extent possible as determined by the facility, the opportunity to receive the pneumococcal and influenza vaccines to each elderly person who receives ongoing care at the facility if a physician, or an advanced nurse practitioner or physician assistant on behalf of a physician, determines that the vaccine is in the person's best interest. However, this does not constitute an offer requirement as the facility may determine that it is not feasible to offer the vaccine to its patients.

[266] For Texas, for medical exemptions to the immunization requirements of 25 Tex. Admin. Code § 97.101(d), see 25 Tex. Admin. Code § 97.101(g), providing that the immunization requirements are inapplicable where the immunization is medically contraindicated, based upon an examination of the child by a physician licensed to practice anywhere in the U.S.

[267] For Texas, for religious exemptions to the immunization requirements of 25 Tex. Admin. Code § 97.101(d), see 25 Tex. Admin. Code § 97.101(g), providing that the immunization requirements are inapplicable where immunization conflicts with the tenets of an organized religion to which the child’s parent or guardian belongs.

[268] For Texas requirements, see Tex. Health & Safety Code § 161.005, 25 Tex. Admin. Code § 97.102, and 25 Tex. Admin. Code § 97.61, relating to facilities of the Texas Department of Criminal Justice and the Texas Youth Commission. Tex. Health & Safety Code § 161.005 requires that on admission to a facility of the Texas Youth Commission or the Texas Department of Criminal Justice, the facility physician shall administer needed vaccinations to the child or refer the child for vaccinations. 25 Tex. Admin. Code § 97.102 requires that the facility physician administer needed immunizations or refer the child for immunization, where needed immunizations are diphtheria, tetanus, poliomyelitis, pertussis, Haemophilus influenzae type b, measles, mumps, rubella, hepatitis B and varicella. 25 Tex. Admin. Code § 97.61 provides that the vaccines required by 25 Tex. Admin. Code § 97.63 are also required for all children in the State of Texas, including children admitted, detained, or committed in Texas Department of Criminal Justice, Texas Mental Health and Mental Retardation, and Texas Youth Commission facilities. 25 Tex. Admin. Code § 97.63 requires a child or student to show acceptable evidence of vaccination prior to entry, attendance, or transfer to a child-care facility or public or private elementary or secondary school, or institution of higher education. Children enrolled in child-care facilities, pre-kindergarten, or early childhood programs shall have the following: (1) age-appropriate vaccination against diphtheria, pertussis, tetanus, poliomyelitis, Haemophilus influenzae type b, measles, mumps, rubella, hepatitis B, and varicella in accordance with the Texas Department of Health Immunization Schedule as informed by the Advisory Committee on Immunization Practices’ (ACIP) recommendations and adopted by the Texas Board of Health and published in the Texas Register annually; and (2) age-appropriate vaccination against hepatitis A for children attending a child-care facility, pre-kindergarten or early childhood programs located in a high incidence geographic area as designated by the department. § 97.63 also provides further information about schedules and dosages.

[269] For Texas, for medical exemptions to the immunization administration requirements of 25 Tex. Admin. Code § 161.005, see 25 Tex. Admin. Code 161.005(b), providing that the exemptions set forth in Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 are applicable. Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 provide that the immunization administration requirements are inapplicable where a licensed physician signs an affidavit or certificate stating that the required immunization poses a significant threat to the health and well-being of the child or a member of the child’s family or household. For medical exemptions to the immunization administration requirements of 25 Tex. Admin. Code § 97.63 and § 97.102, see 25 Tex. Admin. Code § 97.62, providing that exclusions from the immunization administration requirements of 25 Tex. Admin. Code § 97.63 and § 97.102 are allowable on an individual basis for medical contraindications, subject to certain certification and time conditions.

[270] For Texas, for religious exemptions to the immunization administration requirements of 25 Tex. Admin. Code § 161.005, see 25 Tex. Admin. Code § 161.005(b), providing that the exemptions set forth in Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 are applicable. Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 provide that immunization administration requirements are inapplicable where the minor’s parent or guardian signs an affidavit stating that the minor declines immunizations for reasons of conscience, including a religious belief. For religious exemptions to the immunization requirements of 25 Tex. Admin. Code § 97.102 and § 97.63, see 25 Tex. Admin. Code § 97.62, providing that exclusions from immunization administration requirements are allowable where the minor’s parent or guardian submits an affidavit signed by the minor stating that they decline the immunization for reasons of conscience, including a religious belief.

[271] For Texas, for philosophical exemptions to the immunization administration requirements of 25 Tex. Admin. Code § 161.005, see 25 Tex. Admin. Code § 161.005(b), providing that the exemptions set forth in Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 are applicable. Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 provide that immunization administration requirements are inapplicable where the minor’s parent or guardian signs an affidavit stating that the minor declines immunizations for reasons of conscience, including a religious belief. For religious exemptions to the immunization requirements of 25 Tex. Admin. Code § 97.102 and § 97.63, see 25 Tex. Admin. Code § 97.62, providing that exclusions from immunization administration requirements are allowable where the minor’s parent or guardian submits an affidavit signed by the minor stating that they decline the immunization for reasons of conscience, including a religious belief.

[272] For Texas requirements, see Tex. Health & Safety Code § 161.005, 25 Tex. Admin. Code § 97.102, and 25 Tex. Admin. Code § 97.61, relating to facilities of the Texas Department of Mental Health and Retardation. Tex. Health & Safety Code § 161.005 requires that on admission to a facility of the Texas Department of Mental Health and Retardation, the facility physician shall administer needed vaccinations to the child or refer the child for vaccinations. 25 Tex. Admin. Code § 97.102 requires that the facility physician administer needed immunizations or refer the child for immunization, where needed immunizations are diphtheria, tetanus, poliomyelitis, pertussis, Haemophilus influenzae type b, measles, mumps, rubella, hepatitis B and varicella. 25 Tex. Admin. Code § 97.61 provides that the vaccines required by 25 Tex. Admin. Code § 97.63 are also required for all children in the State of Texas, including children admitted, detained, or committed in Texas Department of Criminal Justice, Texas Mental Health and Mental Retardation, and Texas Youth Commission facilities. 25 Tex. Admin. Code § 97.63 requires a child or student to show acceptable evidence of vaccination prior to entry, attendance, or transfer to a child-care facility or public or private elementary or secondary school, or institution of higher education. Children enrolled in child-care facilities, pre-kindergarten, or early childhood programs shall have the following: (1) age-appropriate vaccination against diphtheria, pertussis, tetanus, poliomyelitis, Haemophilus influenzae type b, measles, mumps, rubella, hepatitis B, and varicella in accordance with the Texas Department of Health Immunization Schedule as informed by the Advisory Committee on Immunization Practices’ (ACIP) recommendations and adopted by the Texas Board of Health and published in the Texas Register annually; and (2) age-appropriate vaccination against hepatitis A for children attending a child-care facility, pre-kindergarten or early childhood programs located in a high incidence geographic area as designated by the department. § 97.63 also provides further information about schedules and dosages.

[273] For Texas, for medical exemptions to the immunization administration requirements of 25 Tex. Admin. Code § 161.005, see 25 Tex. Admin. Code 161.005(b), providing that the exemptions set forth in Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 are applicable. Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 provide that the immunization administration requirements are inapplicable where a licensed physician signs an affidavit or certificate stating that the required immunization poses a significant threat to the health and well-being of the child or a member of the child’s family or household. For medical exemptions to the immunization administration requirements of 25 Tex. Admin. Code § 97.63 and § 97.102, see 25 Tex. Admin. Code § 97.62, providing that exclusions from the immunization administration requirements of 25 Tex. Admin. Code § 97.63 and § 97.102 are allowable on an individual basis for medical contraindications, subject to certain certification and time conditions.

[274] For Texas, for religious exemptions to the immunization administration requirements of 25 Tex. Admin. Code § 161.005, see 25 Tex. Admin. Code § 161.005(b), providing that the exemptions set forth in Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 are applicable. Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 provide that immunization administration requirements are inapplicable where the minor’s parent or guardian signs an affidavit stating that the minor declines immunizations for reasons of conscience, including a religious belief. For religious exemptions to the immunization requirements of 25 Tex. Admin. Code § 97.102 and § 97.63, see 25 Tex. Admin. Code § 97.62, providing that exclusions from immunization administration requirements are allowable where the minor’s parent or guardian submits an affidavit signed by the minor stating that they decline the immunization for reasons of conscience, including a religious belief.

[275] For Texas, for philosophical exemptions to the immunization administration requirements of 25 Tex. Admin. Code § 161.005, see 25 Tex. Admin. Code § 161.005(b), providing that the exemptions set forth in Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 are applicable. Tex. Educ. Code § 38.001 and Tex. Educ. Code § 51.933 provide that immunization administration requirements are inapplicable where the minor’s parent or guardian signs an affidavit stating that the minor declines immunizations for reasons of conscience, including a religious belief. For religious exemptions to the immunization requirements of 25 Tex. Admin. Code § 97.102 and § 97.63, see 25 Tex. Admin. Code § 97.62, providing that exclusions from immunization administration requirements are allowable where the minor’s parent or guardian submits an affidavit signed by the minor stating that they decline the immunization for reasons of conscience, including a religious belief.

[574] For Texas, no regulation or statute specifically refers to vaccination against influenza for hospital employees. However, note 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.

[575] For Texas, no regulation or statute specifically refers to vaccination against measles, mumps, or rubella for hospital employees. However, note 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.

[576] For Texas, no regulation or statute specifically refers to vaccination against varicella for hospital employees. However, note 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.

[577] For Texas, no regulation or statute specifically refers to vaccination against pneumococcal disease for hospital employees. However, note 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.

Disclaimer:
The purpose of this database is to provide researchers,
policymakers, and state and local public health practitioners with descriptive
information concerning state immunization-related law. No part of this legal
analysis involves providing legal advice or answering specific questions of law
on behalf of any person or organization.